 Four warning signs that you need to go to your doctor. You know it's time to check in with your doctor if you're feeling absolutely dreadful or if you're due for your yearly examination. But many of the major signs of poor health tend to fly under the radar and are wrongfully chalked up as just being common with age. I'm here to tell you that this is not the case. And if you're not feeling or looking your best, an underlying health issue is probably to blame. That's why today I wanna share four common yet surprising signs that it's time to see your doctor. The first, skin tags, rosacea, which is adult acne. Skin tags are not a normal finding of aging. Personally, when I was in my 40s, I had skin tags in my armpits and down in my groins. And I actually wasn't too worried about them because interestingly enough, the men and women that I was operating on for coronary artery disease also had these skin tags. And I was told by my dermatologist friends that, oh, that's just a normal part of aging. Can you imagine my surprise when I went on my program and began losing weight that my skin tags dried up and fell off? Seriously, it's the most wild thing I've ever seen. And I have tons of patients who follow my program that their skin tags dry up and fall off. So what are skin tags trying to tell you? Skin tags are trying to tell you that you have an elevated insulin level and you most likely have an elevated insulin-like growth factor, IGF-1. These are both growth hormones and there is nothing in us that we want to grow. I assure you. So this was an outward sign that I was growing things. Now they also correlate very well with skin tags growing inside your colon. We call them polyps. And it's very unusual for me to ever see anyone with a colon polyp who doesn't have an elevated insulin level. Women, if you have adult acne, rosacea, I can virtually guarantee you that you have an elevated insulin level. Men, if you are told you have a big prostate or if you're getting up a few times to go to the bathroom at night or it's getting harder to start your stream, I got news for you. Your prostate is being stimulated to grow by an elevated insulin level. And just to reiterate, the last thing you want as you get older is an elevated insulin level. Elevated insulin levels correlate with developing cancer. They strongly correlate with developing memory loss, dementia, Parkinson's, and Alzheimer's. None of which you want. So these are all warning signs that at the very least, have your doctor order a fasting insulin level. It's usually paid for by insurance if it is and it's about $8. And make sure your insulin level is well under 10. I prefer six and less. That's the first warning sign that you can't ignore. Next up, women in particular, persistent episodic feelings of nausea. Now, one of the biggest drivers of death in women is heart disease. It now ranks number one. It never used to be, cancer used to be number one, but heart disease is now the number one killer of women. Problem is, women don't display the classic signs of having a heart attack like men have been taught. Crushing chest pain, an elephant sitting on your chest, achy jaw, pain going down your left arm. As a heart surgeon who's operated on many women having an acute heart attack. Oftentimes the presentation is that of an upset stomach or nausea, particularly after eating and women attribute it to something I ate. But more likely women will present with this nausea or upset stomach, maybe even a little shortness of breath when they're doing the chores, not the elephant sitting on the chest, not the arm pain, not the jaw pain. So if this is happening to you, it's an alert that you gotta go talk to your doctor and say, I think I've got heart disease. Don't let them not work you up for heart disease. So that's number two warning sign. Next, and this is a big one, chronic low energy and fatigue. This is always, almost chalked up as, oh, you're a busy mother or it's common with age or you're a busy executive or you're just not getting enough sleep. What did you expect? Yes, all those things can be a factor. Anyone who's raised, you know, several kids, anyone who has lots of puppy dogs will tell you that interrupting sleep is hard on your levels of energy. But as I can tell you now for the last 20 years, the most common signs of autoimmune diseases of leaky gut are women in particular and men secondarily who complain about chronic fatigue, chronic low energy and your get up and go has got up and went. This is a sign that something is really wrong, particularly in your gut. Remember, Hippocrates 2,500 years ago said all disease begins in the gut and after 20 years of studying this, 20 years plus, I assure you that Hippocrates was right. So if you've got low energy, chronic fatigue, it's not in your head, it's in your gut and you need to find someone who will listen to you. That's the most important. Finally, men, you come looking for a prescription for Viagra, for Cialis, for any of the other male enhancement products. I can assure you that not getting it up is an incredibly scary warning sign that this same process is happening in your heart and in your brain. And this is actually one of the biggest threats to you having a heart attack or a stroke or correspondingly developing memory loss. The fact that you cannot dilate your blood vessels properly is one of the best telltale indicators that you shouldn't be seeing your doctor for a Viagra prescription. You should be seeing your doctor or someone like me to find out what's actually the cause of your erectile dysfunction because that dysfunction is happening in your heart and happening in your brain simultaneously. And it's one of the best reasons to see your doctor and not for a Viagra prescription. You know, I've talked over and over again about the risk of eating too much red meat but if you still want your steak, so be it. But not all steak is created equal. So when you're at the store and you're buying your steak to go home and cook or even if you're at a restaurant, you have to know what to look for and what to avoid and that's why I'm here. And I'm from Omaha, Nebraska, the beef state. And let me tell you, I know beef. In fact, believe it or not, our high school prom were always held at the Omaha Stockyards, no kidding. So beef is my middle name and beef is my game. So you wanna eat steak? First of all, look for grass fed and grass finished beef. Now we love the idea of corn feeding our beef, our cows. Why? Because that corn fed beef is marbled with that succulent, delicious fat that gives us the mouth feel that we associate with a great tasting steak and it makes the steak incredibly tender. But here's the problem. Corn is just pure Omega-6 inflammatory fats. Now traditionally, cows that are fed on grass have in their fat an Omega-6 to Omega-3 ratio of anywhere from three to five Omega-6 parts to one part Omega-3 fat. And that's a natural ratio. When we add corn to the mix, that ratio can go up to 25 to 50 to one instead of the three to five that we're looking for. So that juicy, tender mouthwatering steak becomes an inflammatory fat nightmare. Those fats actually increasingly are becoming realizing as one of the biggest drivers of inflammation in our country particularly. They turn into compounds called aldehydes. One aldehyde that you're probably aware of is formaldehyde, the things that we preserve bodies with. I spent a lot of time around formaldehyde in medical school and I assure you you don't want to eat a steak that turns to formaldehyde in your body. And yet that's exactly what it does. Now the problem with marbling and actually the problem with grass-fed is there's actually no law, no federal law that tells you what grass-fed means. Technically, all cows eat grass for some part of their life. If you then feed them grass for even one day, as an example, and then take them to the feedlot and give them corn and soybeans for the rest of their lives, legally there's nothing to stop the company from telling this is grass-fed beef. What good producers will do is they'll feed them for grass most of their lives, but then to give you the mouthfeel you're looking for, they'll take them to the feedlot and feed them corn and soybeans or corn only for about six weeks to fatten them up for slaughter and to give you that mouthfeel. The way around that is to look for grass-fed and grass-finished beef. Now you see it in some of the high-end markets, you can certainly find it on the internet, but if you're gonna have your beef, that's what you're looking for because it's going to have much better proper ratios of Omega-6 to Omega-3. So labeling is really deceptive and if you have any doubt, contact the company and ask what they do. Now I'm old enough to remember that back in the old days, but even in Nebraska, meat, beef was very expensive and they certainly weren't an everyday thing. And cheaper cuts were what the average person could afford, like a chuck steak or a round steak. They were cheap because they had a lot of gristle and that gristle is actually where gelatin and collagen come from. And it turns out our microbiome actually loves to ferment the gristle and does not ferment muscle as well. So inadvertently, poor people, people who couldn't afford a lot of meat and long-lived people in general were eating these old, tough cuts of meat and they weren't eating very much of it and they were doing one other thing that I think that's particularly illustrative of how we ought to approach beef, lamb and pork in general. So they cooked them all day long. My mother would cook a pot roast all day long for us and we'd have it actually multiple days and that gristle would break down and unbeknownst us, we were actually having gelatin and collagen on almost a daily basis in these meats. We also actually benefited from gelatin almost every day in the form of jello. Now, jello is not a health food, folks, but believe it or not, almost every day of our lives, we were having gelatin in the form of jello. Now, don't rush out and buy jello. There's a lot easier ways to get gelatin into your life. But the point is we were also having a soup in those days called consomme. And in fancy restaurants, you even had chilled consomme as an appetizer. And consomme was simply high-end bone broth. Now don't rush out and buy bone broth because bone broth, the arsenic and lead in bones is actually remarkably high. So be careful when you're eating steaks. And for goodness sakes, please, please, please, avoid the steaks that have all the marbling. You're much safer to have a filet that's grass-fed, grass-finished than a ribeye, even if it's grass-fed, grass-finished because it's gonna have much less of the harmful fats. Now, something that I've been researching for my upcoming book and something I researched in going to countries like Portugal, like Spain, like France, like Italy, is that these people, particularly the poor parts of these countries, use a lot of sausages, fermented meats in their diet. In fact, the country with the longest lifespan is actually a tiny country between France and Spain called Andorra. Andorrians have a lifespan of 87.7 years. Pretty spectacular. And Andorrians do two things. They eat sausages every day. Now, these are fermented sausages. People are poor and they can't waste animals. So they go, they eat everything the saying is from snout to tail. But to preserve these foods, they actually rind them up and make sausages. And the sausages are preserved by fermentation. The fermentation does a lot of really cool things that you'll hear about in the upcoming book. But among other things just to tease you, fermentation makes these incredible mitochondrial uncouplers polyamines. And polyamines promote longevity in multiple ways. The other thing that it does is it breaks down some of the really health destroying compounds that I write about in beef lamb and pork called New Five GC. So these folks, because they were poor, actually got tremendous health benefits by fermenting their beef products. So sausages traditionally prepared from Italy, from Spain, from France, from Portugal are actually pretty doggone good health foods. But that doesn't mean you can go to the grocery store and say, hi, I want a pound of sausage meat or fresh sausage and think you're going to get the same benefit. All contrary, these are not properly prepared and they will do you more harm than good. All right, so if you want to have your meat, have it, but in moderation, of course, fill your plate with vegetables and make meat the garnish. You should also try to decrease your consumption of meat for many reasons that you'll learn about in the new book. But if you want to treat yourself to a steak every once in a while, I get it. When my wife and I have a steak, we buy a filet and we split it and we get the flavor we want, but we're not killing ourselves in the process. Good mineral deficiencies cause occasional fatigue. So fatigue is one of the most common problems I hear from my patients. And while nutrient deficiency isn't always the root cause, it definitely can be, which is why it's so important to be honest with medical professionals about what you're eating on a daily basis. Now here's the first problem. Our soils are so nutrient depleted, we could eat continuously and never get trace minerals that we need. Now I'm not just saying that, this was actually from a Senate document introduced in 1936, you know, almost 100 years ago. 100 years ago, we knew that our soil no longer could support our needs and yet nothing was done about it. What has happened is we literally need these nutrients, our bodies sense the lack of these nutrients and one of the theories about why we overeat is we're constantly looking for these nutrients which we never get and we assume the next bite of food will probably have that because long ago they did. We have killed our soil. Once petrochemicals were invented as fertilizers after World War II, we realized that we no longer needed a living soil to grow plants. That soil had its own microbiome, that microbiome added nutrients from the soil back into the plants but we've killed off that microbiome with all of our herbicides and pesticides and biocides. So basically our soil is now dead and even though our plants look like plants, they no longer contain what a plant 50 years ago would have. So we're deficient in two very important minerals that normally would have come from the soil but now are no longer available. The first is potassium. Now potassium is so important that we keep potassium in our blood at a very specific level and we will take potassium out of our cells and put it into our bloodstream to support that level. It's so essential that if your potassium levels fall too low in your bloodstream, you can begin to have skipped heartbeats, you can have heart arrhythmias. Interestingly enough in heart surgery, we give people potassium drips following heart surgery to keep their potassium levels high, to prevent dangerous skipped heartbeats or arrhythmias. It's so critical for that. Why do we do that? Well we know that most people walking around will have a quote normal potassium on their blood test but that doesn't tell us how much total body potassium is deficient because we'll just keep emptying ourselves of potassium to get enough potassium in our bloodstream. How can this manifest? Some people notice a potassium deficiency by leg cramps or even restless legs. If you notice that at night, particularly following exercise, you get cramps in your legs, potassium's frequently the answer and low potassium is the part of the problem. Now, it also, if you have too much potassium, which is virtually impossible unless you have advanced kidney failure, too much potassium can actually be so subtly suppressive of your heart that it can actually cause your heart to slow down and potentially even stop. Fun fact, we actually stop the heart during heart surgery by giving a bolus of potassium to make the heart stop moving and it takes a while for that potassium to wear off and that's how we stop the heart. So too much potassium is a bad thing but you cannot take enough potassium or eat enough potassium-conveying foods to do that. Sometimes you'll see a high potassium on a blood test. That usually is because the phlebotomist who drew your blood used a very tiny needle or had difficulty getting blood out of your vein and it actually caused red blood cells to hemolyze releasing potassium. That's not an issue. So foods that are high in potassium, spinach, broccoli, avocados, green bananas, and sweet potatoes have great amounts of potassium for you. So think about that the next time you're trying to get more potassium in your diet. Now I particularly like a potassium supplement called potassium magnesium aspartate. The reason I like that is the second most critical a mineral that you don't have enough in is magnesium. Now magnesium is frequently on blood tests but most people don't measure it unless you have advanced kidney failure where for the same reason potassium might be a problem, magnesium can be a problem. So you're sitting here watching me probably deficient in magnesium. Magnesium is kind of the one two punch with potassium for stabilizing cell membranes, for stabilizing the conduction system of the heart and interestingly enough for making muscles work properly. Many people have heard of magnesium as milk of magnesium and milk of magnesium is concentrated magnesium and as anyone who has used milk of magnesium, milk of magnesium will make you go to the bathroom by actually stimulating the muscles in your colon to contract more vigorously. Now you don't need milk of magnesium to get magnesium but magnesium is critically important for muscular work, muscular energy and critically important for heart muscle stability and the electrical system of the heart. So potassium and magnesium, they're so important in your bloodstream that you will keep that level normal even if the magnesium and potassium are very low inside yourself and so it's deceptive for most people whose doctor tells them, oh, you have a normal magnesium, don't worry about it. Almost everyone I see in heart surgery is very deficient in magnesium. In fact, for two days after heart surgery, we give people boluses of magnesium through their veins every six hours to replete the amount of magnesium in their body which is really low in most adults. Now magnesium is also a critical ingredient to help insulin deliver sugar into your muscle cells and people who have low magnesium inadvertently may have insulin resistance that just because they have low magnesium. The other thing that's fascinating with magnesium is that magnesium is incredibly important for sleep and also incredibly important for mood. And as I tell my patients, look, I want you to take some potassium and magnesium before you go to bed, it'll help you sleep, it'll help your mood, you won't beat your dog and literally there's study after study showing the sleep benefits and the mood benefits for magnesium and the combo of potassium and magnesium is just a one, two punch. Most of us are deficient in those two minerals and they're easy to find potassium, magnesium, aspartate tablets or capsules. In general, you wanna look for at least about 99 milligrams of potassium and about 300 milligrams of magnesium and you can find these in combo pills readily easily and they're really inexpensive. Now, believe it or not, many people are low in sodium, particularly people with high blood pressure or heart failure who have been convinced that they should follow a low sodium diet. In fact, sodium is actually an essential nutrient and the problem is a lot of our foods are very deficient in sodium and a lot of us have been told that we have to drink eight glasses of water a day, at least 64 ounces of water per day and quite frankly, there is absolutely no valid science where that number came up from. Water flushes sodium out of us and many people I see when we draw their blood in the morning have had one or two glasses of water to pump their veins up and in fact, they have low sodium and chloride in their blood. One of the scariest things about marathon runner deaths is that a great number of these deaths are not heart attacks from coronary artery disease but rather from their heart failing because of their low sodium and chloride levels because of all the water that they were drinking without electrolytes during the marathon. So how much sodium is good? Well, here's what I want you to do. Salt is a really great way of getting iodine into your body and iodine is essential for thyroid function to manufacture thyroid hormone. 100 years ago, the US government mandated iodine in salt that's where Morton Salt came from, little girl with the umbrella. Recently people have gone for Himalayan salt or sea salt. The problem is that none of these have any iodine. So get yourself some iodized sea salt. It's readily available. It's in almost all grocery stores. There's multiple varieties from around the world. There's French iodized sea salt. There's Baja California iodized sea salt. I'm currently using an Italian iodized sea salt. Mix it up. They all actually have slightly different flavor profiles and have fun, have a salt tasting party but get iodized sea salt and that'll solve your sodium problem and it'll solve an iodine problem. Another critical mineral that I see so many people with low thyroid, if I just get them to start using iodized sea salt, most of the time it comes right up. Are there minerals that people get too much of? Well for one, iron. I'm old enough to remember Geritol that was for people with iron poor blood but as I've written about before, iron ages us. We rust. Women live seven years longer than men because ladies, you get rid of iron once a month for half of your life. Men unfortunately don't wrestle saber-toothed tigers anymore so we have no built-in way of getting rid of iron and iron levels really correlate with aging. In fact, studies after studies show that people who donate blood on a regular basis live seven years longer than people who don't donate blood. So iron is not something that you should be taking as a supplement unless directed by a doctor and if you have low iron, you need to find out where that iron loss is coming from except during menstrual cycles. Calcium, there's absolutely positively no place for supplemental calcium in the treatment of osteopenia and osteoporosis. In fact, calcium that you take as a supplement may actually get deposited in your blood vessels rather than your bones. So please, taking a calcium supplement is absolutely contraindicated. Now zinc, zinc is another essential mineral but zinc supplements can get complicated. Zinc and copper have to have a very balanced relationship and we see too many people thinking, well, zinc is good, I need a lot more but they don't balance it with calcium. Similarly, we see people saying, well, I need to balance zinc with calcium and I'm gonna take copper but usually the amount of copper in a supplement overwhelms what you need for zinc supplementation. In general, about 30 milligrams of zinc is all you need a day and it's easy to obtain in a supplement. All right, lastly, it's worth mentioning that what I've shared is general information and may not work for everybody. If you're struggling with chronic low energy or fatigue, make sure you check in with your doctor. They'll be able to help you identify the cause and put together a plan that works best for you. But look into the deficiencies in potassium and magnesium and iodine as a great place to start in your program. More amazing episodes just like this one, watch now.